A New You Pink Boutique

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

A NEW YOU PINK BOUTIQUE

Practice address

106 W Robertson St
Brandon, FL 33511-5112

Phone

(813) 661-7465

Fax

(813) 661-7465

NPI assigned

Oct 20, 2011

Last updated

Oct 20, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gary PooleNPI 1316914724

Title

Owner

Phone

(813) 661-7465

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary Lee Poole, ANP

  • Family Nurse Practitioner
  • Stamps, AR
  • NPI 1316914724
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1740565860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W ROBERTSON ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115112",
            "telephone_number": "813-661-7465",
            "fax_number": "813-661-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W ROBERTSON ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115112",
            "telephone_number": "813-661-7465",
            "fax_number": "813-661-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A NEW YOU PINK BOUTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-661-7465",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 202 Beverly LLC (Refuge At New Life House)
• 702 S Kings Ave Opco LLC (Aviata at Central Park)
• 702 South Kings Avenue Operations LLC (Central Park Healthcare and Rehabilitation Center)
• 813-522-9755
• A Kid's Place of Tampa Bay Inc.
• A Place to Grow LCC Alf
• Aaxiom Health Services, Inc. Dba Home Instead Senior Care (Home Instead Senior Care)
• ABA 4 Care Solutions LLC (ABA 4 CARE Solutions)
• ABA Family Bilingual Services Inc
• ABA of Tampa Bay, Inc.

• Durable Medical Equipment & Medical Supplies in Brandon, FL
• Providers in Brandon, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.